Despite regulatory initiatives, psychopharmacological treatment of adolescents is challenged by missing trial data on efficacy and safety. An estimated mean off-label prescription rate of 30-40% in Danish clinical child- and adolescent mental health services (MHS) has been found. Lowest rates were found for ADHD drugs (2-3%) and highest for antipsychotics (96%) and melatonin (100%). The use of melatonin is growing, while the use of other psycho­pharmacological drugs seems stabilizing or decreasing in spite of more adolescents treated in Danish MHS.